HomeMy WebLinkAboutSUBSPLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CONTRACTOR S[ TURE ( alifter)
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PRINT NAMF
COUNTY CERTIFICATION NUMBER
State of Florida, County of SA• \3%L (_
The regoing instrument was signed before me this day of
��. by , 20L; r
who is personally known -or has produced a
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STAMP
Signature of Notary Public
Print Name of Notary Public
Notary Public State of Florida
Christine A. Marsh
M My Commrssron HH 026766
?osa ExgreS08102/2024
Revised 11/16/2016
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SUB CONTRACTO
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PRINT NAME
COUNTY CERTIFICATION
^N,UMBER
State of Florida, County of �tC . Lei Q
The foregoing instrument was signed before me this i a day of
20 fl-
y
who is personalty known Yor has produced a
as id stion.
v
STAMP
Signature of Notary Public
i row
Print Name of Notary Public
[VyNPublic Slate of Fkxrda
Christine A. Marsh
�* MY Commrssron HH 026766
a.dF ExpuesOB/02/2024
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the
PERMIT #
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(Type of Tra(
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building o& rfirla
yirioiun
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Ce721C1�OLerr i a vu
e/Individual Name)
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For the project loc4ted at
have agreed to be
Sub -contractor for 100,0i S' 6 2 e e
(Primary Con actor)
(Project Street Address or Property Tax ID #)
It is understood tif
, if there is any change of status regarding our participation with the above mentioned
project, the Buildg and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change Sub -contractor notice.
Z
State of Florida, County a
The foregoing instrument
,20_
who is personally known
as identification.
of
Revised 11/16/2016
5A_ W-c-1 f�
assigned before �me this day of
by —/1 N 1✓'p / F ! %�
i
for has produced a
SUB -CON R CsNATURE (Qualifier)
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PRINT NAME
/ 9 8 3/z
COUNTY CERTIFICATION NUMBER �1
State of Florida, County off `� _?
The foregoing instrument was si d beforfeJ me this day of
I , 20'� by
who i ersonally known _fir has produced a W
as identification.
I
STAMP
Si nature of Notary Public / STAMP
-�Nwa-5 L. I n is
Print Name of Notary Public
ar�saY Pag4 Notary Public State of Florida
A Thomasina Bowins
My Commission GG 201733
wo ad Expires 03/29/2022
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(Votary Public State of Florida
A Thomasina Bowins
My Commission GG 201733
Expires03/29/2022